Episode Transcript
[00:00:00] Jeff Tiessen: Welcome to Life and Limb, a podcast from Thrive magazine, all about living well with limb loss and limb difference. I'm Jeff Tiessen, publisher of Thrive magazine and your podcast host. My guest this episode founded an organization that supports the rehab and prosthetic needs of amputees in sub-Saharan Africa. And that being the regions of the continent that lie south of the Sahara. Tom Williams, he used to work as a strategist with top tier companies, but says his heart always leaned toward creating lasting social impact. And so now he's bridging that gap for non-profit and for-profit organizations to get people back walking, dancing and playing again, as he says. So, Tom Williams, welcome. How are you and where are you?
[00:00:53] Tom Williams: Yeah. Wow, what an introduction. Thank you, Jeff. So, yeah, my name is Tom, founder of STAND, formerly Legs for Africa, and I'm speaking to you today from Wales. Yeah, in the hills of South Wales, UK.
[00:01:11] Jeff Tiessen: Very nice. Yeah, thanks for joining us. I really appreciate it. And like I said in our intro before we were recording, I've known about your work for so long and it really is a pleasure to meet somebody that's making a difference for the amputee community, wherever that may be. So, let's start with STAND. Is it an acronym? What's the meaning behind the name and why the change from the original name, Legs for Africa?
[00:01:37] Tom Williams: Yeah. Wow. Jumping straight in the deep end. I like it. So, yeah, I want to give a bit of a backstory about where Legs for Africa has come from because there's definitely been an interesting story arc. I started the organization just over 10 years ago, back in 2013 after a trip to the Gambia. I was actually going through a bit of a difficult period of my life and a friend, an old school friend, was going through something similar. And we said, hey, we need to get out of here. Let's go on holiday. And we picked the Gambia. We fancied a bit of an adventure, something a bit different.
And on the first day of being there we met this beautiful family, and the father. So, the guy that we'd met was actually a chef in this restaurant where we ate. And yeah, we complimented the food and he said, if you like that, you'll love my mother's cooking and invited us to his family's compound the next day. And as it happened, his mother's cooking wasn't quite as good as his. But we got to know the whole family and we really had an interesting and beautiful experience. And the father of the family was an amputee. He'd lost his leg through diabetes.
And from getting to know him, I could see that he was not just experiencing a kind of physical trauma, but there was an emotional trauma there as well. Like, he had clearly been the breadwinner of the family and now he kind of relied on everyone to do most things for him. And I could see the strain that it put on the family and the community, and not coming from a prosthetics background myself. I said to the family, look, when I get back to the UK, I'll see what I can do about getting your dad a prosthetic leg. I don't know what the process is, but I'm willing to explore that.
So, anyway, there is one rehabilitation center in the Gambia, and it's a very small country on the west coast of Africa. And we managed to get some pretty basic measurements of this chap's stump. And from that I was able to find someone in the UK, who was an amputee himself, he was a prosthetist, and he agreed to build a prosthetic leg in his spare time and sponsored the materials. So, a few months later, I was able to fly back out to the Gambia and deliver this leg. And at the time, it was just a random act of kindness, for lack of a better word.
And on a personal level, for me, I always knew that. So, this was something nice happening, you know. I was holding this prosthetic, and taking it to the Gambia, and actually turning up at this family’s compound, and we had the local prosthetist there and some minor adjustments needed to be made. But we got Paul walking, we got him standing up. Yeah, I emphasize standing. And it was just probably the most incredible moment of my life. And I'm not even the one having a new prosthetic leg fitted, so I can't imagine how he felt. But for me, it felt so easy. All I did was connect two dots. Someone that needed something with someone that had something.
And I think that's the principle of how Legs for Africa formed. We identified that there was a need, and particularly in the Gambia. They've got a massive problem with diabetes. Yeah, diabetes and road traffic accidents. Diabetes is the main cause of amputation in the Gambia. Other countries that we're working in, and I can expand into that later, it's actually road traffic accidents.
But we then quickly realized that there was a large amount of prosthetic legs being thrown away in the UK and that prosthetic legs are mostly modular. You've got a foot, you've got a pylon, you've got a knee if you’re an above-knee amputee and a couple of adapters and the different manufacturers’ components are interchangeable. So, it was just like, whoa, okay, so no one's doing this already. Why not? And it just felt like a no brainer.
Giving you a very long version of this story, but I'm going for it anyway. So, for the first five or six years of operating it was all about recycling legs, building relationships with rehabilitation centers. We started off in the UK, then Canada. We've got a representative in Canada. We've got a representative in the US and Europe. It works. It's simple. We offer a collection service to rehabilitation centers. They send us either dismantled legs or whole legs and then we work with groups of retired men to dismantle those legs into their components. We check the components for suitability and then we send them on to partnering and vetted rehabilitation centers, Sub Saharan Africa. So, we've only worked with that rehabilitation center in the Gambia to start with.
[00:08:18] Jeff Tiessen: Were you able to meet the need?
[00:08:19] Tom Williams: We’re able to provide them with enough components to fulfill their annual fitting capacity, which is, I think it's just over 100 amputees a year. So, then we expanded into other countries.
[00:08:38] Jeff Tiessen: Tom, meanwhile, you left a corporate job where you were a strategist or working in management and brand development. So, there had to be a personal decision there that… I'm leaving that to this and the nonprofit sector. And you had talked about it in something I read about you, that there was something that really resonated for you and is it that story you just told about Paul or was there something within you that needed to make this transition?
[00:09:10] Tom Williams: There was a few things at play there. Yeah. I was getting tired of the corporate world. I wanted to earn enough money to get by, you know, I want, you know, simple things. It's about simple things for me. And so, I enjoyed work in the corporate world for the challenges that it offered. I like different projects to kind of get my hands into work, work out how best to do things. So yeah, that did serve me well prior to making the leap to not for profit. And I was quite privileged to be able to. Basically I had my own company where I was able to just work like one or even two days a week. And that was enough to sustain me whilst I was able to grow the organization. It was about three or four years ago now.
Yeah, the year before COVID. I was getting so tired of wearing these two hats. One hat was flying out to Dubai doing all this corporate stuff for cars and stuff, and I don't even like cars. And then this other hat, it was like, oh, that guy who recycles prosthetic legs. So, you know, it was quite tiring to have these two very different hats. And the guy that recycles prosthetic legs was the really happy guy. Like, I enjoyed doing that because it is not just the act of recycling legs, but what it meant. What it meant for the environment, what it meant for bridging the gap between people and communities that don't have access to these resources. Bridging that gap.
Yeah, that's what really made my heart sing. So, I was able to grow the team to six people. Basically, there were six people. And by this point we'd started expanding and acknowledging that rehabilitation isn't just about prosthetists having the right resources, physical resources, the components to get someone walking again. There's way more to it than that. I'm not going to go into that because I'm still trying to answer your question. Stand. So Legs for Africa described what we did. It was very useful for talking to people who we were receiving our resources from, whether that was prosthetic legs or, you know, asking for money because we're a nonprofit.
Yeah. Legs for Africa. Don't need to do too much explaining about what we do. Yeah, I can fill in some gaps here or there, but as people like to say, it says what it does. But yeah, we grew and were expanding our support into different services because we work with a lot of implementing partners and yeah, integrated into different communities, whether that's amputee communities or the professional communities on the African side. So, yeah, we realized that Legs for Africa isn't actually very empowering to the people on the African side.
[00:13:39] Jeff Tiessen: So, evolution of the name then to be more reflective of?
[00:13:44] Tom Williams: We want to be more reflective.
[00:13:45] Jeff Tiessen: Yeah, I can see that in that name.
[00:13:49] Tom Williams: Yeah. We also wanted to acknowledge that there's our responsibility, not just as a not for profit, but I think for any organization about this decolonizing narrative. And what is Legs for Africa saying? I mean, it could be saying that the global north are the gift givers and Africa is this passive receiver of aid. So, we had a really beautiful process which started probably just over two years ago now, but members of the team were starting to sort of notice that there is tension. Something wasn't quite right. Project managers were acknowledging that their area of work wasn't being acknowledged, communicated about in the way that was typical for Legs for Africa, and recycling prosthetic legs. Because that was like our sort of primary narrative, but there's so much more going on.
[00:15:10] Jeff Tiessen: So, in a sense, it was too charitable? Would that be a good description? It had that feel of charity?
[00:15:20] Tom Williams: Yeah. Yeah, I think. Yeah, I think you're right. And so, we entered the mediation process. We had one of our trustees, who's got a lot of experience in mediation, hold this conversation for us as a group that lasted about nine months. And the rebrand was just one of the things. One of the quite a lot of things that came out of that. And I mean, it was a challenging period, but, boy, am I glad we did it. Like, the whole process has galvanized us as a team. Because most of our team members operate mainly from the UK, but we've got people that represent us around the world. Collection ambassadors.
But also, our African stakeholders. And as I mentioned, the communities that we're part of. We really brought those guys into the conversation and had an incredibly rich conversation where we got everyone's voices on the table and really had it that everyone heard. So, stand. What does it mean? There isn't an acronym there. It just means stand. To stand.
When we were going through the rebrand process, initially, we wanted something that had movement in it and felt that it was quite empowering. But actually, we discovered that to stand up is actually a really significant milestone for someone's rehabilitation journey who has gone through limb loss. And with a tagline, we walk together. Yeah. For me, that bridges it. That's, bridging the gap with inequality.
[00:17:41] Jeff Tiessen: Thanks. I thought that was going to be a short answer, but I really appreciate the way that you gave us a very contextual understanding of what the organization does. And speaking to that, you did mention team. I want to talk about that. That process, almost like a flow chart, maybe just some key points. I'm a double arm amputee, but if I was a lower extremity amputee, and for the prosthesis that I was issued or dispensed here in Canada. How does it get from me to someone in the Gambia or another part of sub-Saharan Africa? Is somebody knocking on my prosthetist’s door saying, you got anything laying around? And I don't mean to be dismissive of it, but how does that work?
[00:18:36] Tom Williams: Yeah, that's a great question. There's a big communications position here because we really want to be positioning ourselves within the prosthetics industry. And our question to the prosthetics industry is, is it possible that the prosthetics industry can become a zero waste industry? And I believe firmly that it can, and I'm optimistic that it can as well. And I think for it to do that, we need to have conversations right through the supply chain, manufacturers, suppliers, clinics, national health services, and then. And the individuals themselves, the users.
Yeah, accidentally we've positioned ourselves as I think a big part of that solution in how the prosthetics industry can become zero waste. So. we work with rehabilitation centers. We don't usually go knocking on prosthetist doors. I would love it if we could, but a lot of it's done through LinkedIn, building connections through LinkedIn and directly contacting rehabilitation centers.
And we also find that prosthetic limb wearers can sometimes be putting pressure on their prosthetist or clinic to be getting on board with the solution. Right. Because all they need to do is have a section, a tote box, or something that they can put unwanted returned prosthetics dismantled in a box. And when that box is full, we just ask them to let us know. There's a process on our website. It's pretty simple. Just let us know how many boxes you've got and the address and we'll arrange for a courier to pick it up.
[00:21:12] Jeff Tiessen: So, when you say we here in Canada, there's a point person that they would connect with, or directly with you?
[00:21:20] Tom Williams: It would come directly to us. We would arrange the courier. Yeah, like that doesn't need to happen from Canada. And then we'll arrange for it to be collected from wherever the clinic is. And our collection hub is in Newfoundland. In Cornerbrook.
[00:21:44] Jeff Tiessen: And then the componentry goes to a central, not fabrication, but almost defabrication, disassembly centre?
[00:21:53] Tom Williams: Yeah, right, exactly. So, yeah, items will be dismantled and checked in Cornerbrook and then from there we'll arrange things. Historically we've arranged a shipment every 12 months from CornerBrook and I think we're currently rescuing about 300 prosthetic legs a year across Canada and across everywhere where we operate I think we're at about 2,200 this year already. And overall, since we've started, we're just over 19,000.
[00:22:41] Jeff Tiessen: Wow. How many countries do you draw from? Do you source componentry from?
[00:22:45] Tom Williams: There's Canada, us the UK and then Europe is a bit sprawling, you know. I'm not going to list off all of the European countries, but yeah, I mean, mostly like West Europe. Yeah. Scandinavia as well.
[00:23:06] Jeff Tiessen: Okay, so let's get back, you know, and into Africa. I would imagine that the landscape of prosthetic care and rehab services is a bit different than what we would understand it to be here in our own country. And I would imagine there's a huge population of those that need that kind of service in Africa, so that comes with challenges, no doubt. And what are some of those barriers that Stand needs to overcome? I mean, obviously accessibility and affordability and equipping the process with the tools and materials they need. Is it more than that? What are the biggest hurdles?
[00:23:52] Tom Williams: Yeah, okay. I'm smiling because I'm not happy about the situation, but I'm just trying to condense the really big answer into something that's smaller and yeah, I think to just draw on our mission statement, which I can't remember what it is word for word now, but it goes something like that, Our mission is to make prosthetic devices more accessible whilst improving the quality of service that people receive. And actually, it's not just about access to prosthetic legs, but more like holistic rehabilitation, the rehabilitation that people need.
And with that, it's quite complicated. Another reason why we jumped from Legs for Africa is we're not supplying to the whole of Africa. We're working in eight countries that are in Sub Saharan Africa and each one has their own unique challenges. So, we can't say one size or solution fits all. We work with each rehabilitation center and there's 13 of them across those eight countries and they've all got unique challenges. We understand. We get an idea of what their annual fitting requirements are and they'll each receive an annual consignment from us. The aim is one, but it usually ends up being more.
And they each get a budget as well, because we want to be improving the quality of service and sometimes that means making sure the toilets are working or fixing the leaky roof or whatever it might be. They might need a new oven or any type of machines, whilst upskilling staff as well. So that's another programmatic area that we're working in. But yeah, when it comes down to challenges for users, well, not necessarily users, because people that haven't necessarily been fitted with the prosthetic, it's so complicated. There's the environment as well.
[00:26:53] Jeff Tiessen: I was going to ask you this, are you welcomed or is there resistance?
[00:26:59] Tom Williams: We're very welcomed. No, that's not the problem. There's a lot of social stigma and I've got to be careful here. I don't want to make broad, sweeping statements, but in a lot of communities, if someone has lost a leg, a lot of people believe that that's God's way of punishing them for a crime that they haven't committed yet. And I've heard all. I've heard all sorts of variations of that, but it often means that people are further ostracized and families can be ashamed. So, what tends to happen is people are hidden away.
The project started in the Gambia and I remember when I first got there. I remember seeing lots of people, lots of amputees. A lot of them were begging. Yeah, now there's different amputee community groups there. There's an advocacy group, there's a women's banking group, there's a football team and there's also a community of amputee support, peer support volunteers that go out and meet, whether they've been newly amputated or they're existing. And there's a team of counselors as well in the Gambia. And this has, I think the word is like desensitized, helped normalize.
[00:29:06] Jeff Tiessen: Well, that's definitely an attitude shift, you know, at minimum. And maybe it could be argued that that's, you know, the seeds of a cultural shift as well in terms of bias and stereotype and assumptions.
Or as you said, I guess it would be fate or destiny, I'm not sure. But the punishment aspect of it. Yeah, that's really interesting that you have to work with that alongside other challenges. I like what I had heard and read about, all of the pillars of what Stand does, but interestingly that one particular pillar that talked about historically how the prosthetic profession is male-dominated, which I don't think is exclusive to Africa. I think that's a worldwide situation. So, one of your pillars, back to that, is training female prosthetic technicians, if I have that right?
We here in Canada talk diversity and equity and inclusion and how important that is and, you know, speak very high-level globally about that. But more female professionals in the sector is crucial for you and Stand for several reasons, right? And I'd like you to address why that's important, and why are you leaning into that quite heavily?
[00:30:35] Tom Williams: Great question. We believe it makes healthier work places, work environments when there's a better balance of males and females than just fully males. I think there's also the piece about making safe spaces as well for female amputees that are accessing the rehabilitation services. Having a prosthetic leg fitted can be an incredibly intimate process.
And yeah, so there's a piece around making that process safer and feel safer for women. And we're starting to get pretty good now at collecting data on patients that come through our partnering centers. And it looks like about two thirds of patients are male and yeah, the remaining are female. And it's not entirely clear why that is. It's quite likely that men are more accident prone. But yeah, I'm coming from a place of assumption there. But what if women didn't actually feel safe coming into these places? So, yeah, there are lots of reasons why we're investing in women to get into the prosthetic sector and it's not ourselves that provide the training. We offer training bursaries. And so, we're sending women to one of the two prosthetics universities in Africa, the others in Togo, and I don't know how many we've got currently in play that are currently studying, but we've had the best part of 15 now that have graduated. And then they're now in placement. A number of them are in centers that we've got that we're already working with, and some are working with different centers.
So. Yeah, and there's also a bias in the introduction, not introduction, what's the word I'm looking for when we bring the ladies on. There's a strong bias towards ones that have been affected by limb loss. So yeah, it's a very successful project.
[00:33:55] Jeff Tiessen: Yeah, commendable. That's again a great, great pillar of all the work that you do. As we move to the end of our chat I want to get back to the visionary side of things. The big question. And you had talked about the mission and this question speaks to that a little bit. And I understood in that mission that Stand someday hopes to be redundant and not needed. And that's a big aim. That's a really huge aim. I mean, that everyone would be served as they're needed. That's not even happening here in Canada. There are still affordability issues and amputees that are not getting the prosthetic componentry that would be most appropriate for them. So, what's the plan Tom? I mean, how are you going to do that?
[00:34:48] Tom Williams: I think it's healthy for any not for profit organization to try and put themselves out of business to try to fulfill their mission and vision to a point where they're not needed anymore. And yeah, you could say, well, recycling prosthetic legs, that's not sustainable but for us that's not the end goal. It's the best solution that we've currently got to addressing a problem.
But just that very act of enabling rehabilitation centers with these resources can possibly create a market where manufacturers, suppliers, can go in and offer a service that is affordable to the local communities. But yeah, we recognize we need to keep our fingers on the pulse because times are changing. A lot of these components now are becoming more electronic. We're seeing more knees and feet becoming more electronic and they're going to be talking to one another. They're going to become more affordable so people National Health Service is going to be able to afford that and we, as it stands, we can't recycle the electronic items.
So, I'm not too sure what's going to really happen there. But the best thing we can do is know that it's coming. We're in the process of developing a low-cost energy storing foot and this is one of our areas of research and development. We're working with different groups to develop different low-cost solutions that can be manufactured domestically and that would be great. We're exploring a few different options at the moment. We've just completed a successful trial on 50 patients with this energy-storing foot that I spoke about. So that's going to be scaled up in 2025 to 200 people.
And yeah, there's something about the word sustainability which I don't really like. I mean, I like sustainability, don't get me wrong, but I hear it used out of context a lot of times. Not many things are really sustainable. Nature is sustainable, but most things that humans do isn't. So, I believe we can aim to move towards sustainability, but to really get there, truly get there is a very difficult thing to do. But nonetheless, I think we should strive for it.
[00:38:10] Jeff Tiessen: Yeah, I'm hearing what you're saying. Important to keep a lens on it and not back burner it, so to speak. Last question to you. How do we Canadians, end users, us amputees, our practitioners, how can we help Stand?
[00:38:30] Tom Williams: Yeah, love this question. I'd say head over to our website Stand NGO and there are a few ways that we invite people to engage with us. If you've got a prosthetic leg that you no longer need, we would love to receive it. So, there's a page to contact us through that if you believe that your prosthetist or rehabilitation center isn't on board with our program. We would love you to put a bit of pressure on them. Just have a conversation. And please direct them our way. And we love it when people do some fundraising events for us.
We just recently had a lady walk up Kilimanjaro for us. She lost an arm and a leg in a rail accident a few years ago. She a British lady and she's just raised over £20,000. So yeah, we absolutely love it when the community do fundraising events for us. So, please head over to our website, Standngo. We've also got a docuseries where we've got some beautiful footage of what happens behind the scenes and there's an opportunity to meet some of the incredible people that we work with and support. So yeah, please sign up to our docuseries.
[00:40:17] Jeff Tiessen: Yeah, you're reading off my script here. I did want to make sure our listeners know about that. It is really powerful stuff and it highlights not just what Stand does in the clinic, but how that translates into real life for people. As amputee brothers and sisters, we know the importance of that work from our practitioner. So, really well done. Worth the watch. Please, please check them out, again at Standngo.
And with that, Tom, thanks so much. This was so insightful in giving us a perspective on your life and how you came to do the work that Stand is doing. I really hope we here at Thrive can get even more behind that in promoting your cause and supporting it. So, thanks again.
[00:41:07] Tom Williams: Yeah, thanks, Jeff. I really appreciate you giving me a voice and helping get this story heard. And yeah, I know you've been sharing our work for a good number of years now. I really appreciate the ongoing support.
[00:41:23] Jeff Tiessen: Our pleasure. So, with that, this has been Life and Limb. Thanks for listening. You can read about others who are thriving with limb loss or limb difference and plenty more at ThriveMag.ca and you'll find our previous podcast episodes there as well. Until next time, Live. Well.
